This story dates back to Circa 1985 when I was a ‘wet behind the ear’ fresh MBBS graduate. I was working in a Hospital as a Junior Doctor.
I was on call every alternate night and during these call nights I had to attend to all patients presenting in the casualty and all emergencies in the wards. I had a room in the Hospital Guest House which was fairly decent.
In those days getting a landline connection took 4 years, forget about
cell phones. So calls were written in a notebook by the nurse on duty and hand delivered to the Doctor on call. These were predictably worded like, “Respected Dr. on call,
A patient with fever has presented to the casualty so kindly come and see.” There is a joke whether true or not but it’s part of folklore, once the duty Doctors got this call, “Respected Dr. on call, A patient has presented in the  casualty unable to pass urine. So please come and pass urine.”
The hospital was mainly staffed by student nurses doing their training and night duties were done almost exclusively by these students. Majority of them were from Kerala with highly accented Hindi. They came bearing the call in pairs. I am a night owl and once I sleep I have difficulty in getting up so I would normally remain awake late during call days. Foot falls on the path leading to the guest house would herald an impending call. This is followed by louder foot falls in the corridor as soon as they enter the guest house, then a momentary silence outside my door, some mumbled conversation in Malayalam followed by giggles and then a tentative knock. I open the door and promptly the call book was thrust into my hand. Predictably it read, “Respected Dr. on call,  A patient with bleeding has come to the casualty so kindly come and see. “Kahan se bleeding ho raha hai?”(from where is the bleeding?) I ask irritably, “Pata nahin” (don’t know), comes the reply followed by further giggling. Now I am ready to explode but better sense prevails and I pacify myself with thoughts like “forgive them for they know not the language” and “be kind to dumb animals.” I hand back the call book to them and say “Okay.” Which they promptly hand back saying “Call sign kar do (sign the call). ” I almost have an apoplectic fit but control myself and sign the book. Then I change from my night clothes cursing the loss of sleep and the patient for bleeding at this time of the night.
The walk from my room to the casualty is fairly long and during this walk my mind goes through the possible case scenarios. The patient may have got cut accidently or having blood in stools or maybe vomiting blood. On reaching the casualty I am shown a young lady, she is obviously from a poor socioeconomic status. Her saree and jewellery suggested she is newly wed and her head demurely covered with her saree pallu. I ask her what her problem was, in reply she looks down and adjusted her head cover to completely cover her face. Meanwhile another elder lady amongst the retinue of relatives accompanying her piped in, “isko BP ki bimari hai” (she is sufferng from BP), further confusing matters. Finally a sensible lady amongst the accompanying crowd presumably her Mother-in-law, said “sachi baat yeh hai ki inki nai shaadi hai” (the truth is they are newly wed), pointing out to her son who seemed to give a self satisfied smirk back at me. “Aaj isko bahut khoon beha raha hai” (she is bleeding excessively today). I then examined the patient, her sanitary napkin was soaked with blood and  more blood was trickling from the vagina. I knew I was out of my depth so I sent a call to the gynaecologist. Meanwhile I asked the patient how this had happened? The patient in absence of her in-laws was more vocal, “gandhe kaam kar rahe the” (we were doing dirty things).
The gynaecologist was a middle aged spinster who like all middle aged unmarried gynaecologist was crabby. They tend to vent their irritation on their patients. Perhaps an undercurrent of envy ran in them of not have gone through these natural stages in life but being forced to witness others enjoying it. After scolding the relatives for not coming earlier and generally not taking care of the patient, she examined the patient. “Yeh toh post-coital bleeding hai (this is post-coital bleeding)!” She tells me. Inform the anaesthetist and prepare her for exploration.
The Anaesthetist was the reigning Queen Bee of the Hospital, known as ‘Kalra Bai’ to all and sundry but not on her face. She lived in the hospital campus and her quarters were so strategically located that she had to barely walk a few feet to reach the operation theatre complex. During the day her anaesthesia was interspersed by visits to her kitchen. She would do the fine juggling act perfectly between the anaesthetised patient and the required number of ceetees of the pressure cooker. The food in her house was always perfectly cooked. She was a fount of information about everything from solar cookers which she had installed to various fabrics and where it was available. We were bombarded by her monologue whenever we were operating. She never wasted her time, after the patient was anaesthetised she always had some needle work or handicraft she was working on in her bag.
After Kalra Bai was informed and the patient was taken into the operation theatre. I scrubbed up to assist the gynaecologist. Under anaesthesia we could examine the patient properly. The tear began from the introitus on to the left lateral wall of the vagina, upto the cervix and went halfway around the circumference of the  cervix. The gynaecologist efficiently sutured the entire tear with catgut. I had not seen so much destruction from an act of love. I asked the gynaecologist whether this was possible in the normal course, to which she replied “Yes if the lubrication is not adequate.”
But I was not convinced, especially since we had gone through all the possible sexual perversions in forensic medicine. It even has a scientific name ‘polyembolokoilamania’, meaning insertion of foreign objects into the vagina. In this case the husband appeared to be the guilty party, which explained his smirk.
A case scenario emerged in my mind, the husband is a sadist in addition is impotent. In this pre-viagra era he compensated for his lack of rigidity by using a ‘danda’ (staff).
I decided to do some investigations of my own. So I waited for the next day and for an opportune moment when there were no relatives with the patent. After the niceties of enquiring about her health, I mentioned that there was considerable damage. Then I again placed the question, how did it happen? The reply from the patient was “Bataya na Doctor, gandhe kaam kar rahe the (I already told you Doctor, we were doing dirty things).
If she had said “we were having sex,” I would have questioned her no further, however she chose to state it euphemistically.
The word ‘sex’ is taboo and is considered dirty. However the ‘dirty things’ could also mean perversions. So I persisted in my questioning, “kya gandhe kaam kar rahe the?” (What dirty things were you doing?) Her reply was “jo shaadi ke baad karte” (what is done after marriage). This should have satisfied me but I was so convinced that there was perversion involved I persisted in my questioning. Now I framed my question in a more direct manner to avoid an ambiguous answer, “kya lakdi istemaal kiya?” (Did he use a stick?)
The patient had the most incredulous expression on her face which changed briefly to pity, “kya Doctor aap itne nadaan ho, aap ko yeh bhi nahi pata ki shaadi ke baad kya karte. Kabhi lakdi istemaal karte?” (Are you so innocent Doctor that you don’t know what is done after marriage. How can he use a stick?).
I beat a hasty retreat and remembered the quotation in Bailey & Love, “The ward is your library and the patients are your teachers.”